磁共振成像在转移性卵巢肿瘤的应用现状

Application of MRI in Metastatic Ovarian Tumors

MRI凭借多方位成像和良好的组织对比度,在评价卵巢肿瘤的良恶性时具有重要的诊断价值。然而,鉴别原发卵巢恶性肿瘤（POMT）和转移瘤（MOT）的特异性MRI征象尚未见报道。MOT占所有卵巢恶性肿瘤的10%~30%,与POMT在影像及病理上非常相似,两者的鉴别很困难。不同原发肿瘤的MOT有各自特征,如K r ukenberg瘤典型表现为双侧、实性、T2WI上非均质信号的肿块;结肠癌的MOT常为双侧、伴不同大小实性成分的囊性肿瘤;源自阑尾的MOT常为双侧卵巢黏液性肿瘤,伴腹膜假性黏液瘤。近年来功能成像如扩散加权成像（DWI）、灌注加权成像（PWI）及磁共振波谱（MRS）的发展和应用,使MRI在卵巢肿瘤的鉴别诊断、预后及疗效评价等方面发挥越来越重要的作用。

MRI provides exquisite views of the pelvic anatomy through its high spatial resolution and tissue contrast,and plays a key role in distinguishing malignant from benign tumors.However,there are no highly specific radiological features that differentiate primary from metastatic ovarian masses（MOT）.MOTs account for 10-30%of the total malignant ovarian tumors,and there is an overlap in the imaging appearances of primary ovarian malignant tumors（POMT） and MOT,which causes a diagnostic challenge for radiologists.MOT of different primary site have their own characteristics.Krukenberg tumors are typically bilateral,tabulated,and solid tumors.MOT from colon cancer show a bilateral and predominantly cystic masses with smooth margin,closely resembling the appearance of primary ovarian mucinous tumors.Ovarian involvement by appendiceal tumors is frequently bilateral ovarian mucinous tumors with pseudomyxoma peritonei.Funtional MRI techniques such as diffusion-weighted imaging（DWI）,perfusion-weighted imaging（PWI） and magnetic resonance spectroscopy（MRS）,may play a larger role in the differentiatie diagnosis,prognosis and treatment evaluation of ovarian tumors.